Inequality in the United States has never been more apparent, especially in the wake of the COVID-19 pandemic. In a time when higher income correlates strongly with longer life expectancy, one study found that food and agricultural workers in California had an almost 40-percent higher risk of dying in 2020 compared with the state’s general population. This discrepancy is due to a host of factors including low wages, harsh immigration policies, and a lack of public health funding. Now, a new article in Nature explores the specifics of the burden of disease by social status.
What Explains Differences in Disease by Social Status?
What does 19th-century Prussian doctor Rudolf Virchow have in common with U.S. sociologist W. E. B. Du Bois? Per Nature writer Amy Maxmen, both men explored the “social determinants of health,” a concept that has “been around for at least 150 years” but gained stunning recognition during the height of the COVID-19 pandemic. Of course, there are countless reasons for such disparities in public health outcomes. Per Maxmen, those reasons include systemic discrimination, labor exploitation, low wages, lack of access to affordable housing and education, and inadequate access to healthcare in low-income communities. All of these factors drive home an unfortunate truth: that low-income workers in the U.S. are more likely to have poor disease outcomes than wealthier individuals.
Social Determinants of Health by the Numbers
Although the medical community has certainly advanced since the days of Rudolf Virchow and W. E. B. Du Bois, the aforementioned “social determinants of health” have only grown more stark. In Nature, Maxmen cites one article showing that, by 2014, “the wealthiest one percent of men in the United States were living 15 years longer, on average, than the poorest one percent of men.” Unfortunately, that discrepancy is likely to grow in the coming years. Last year, The Lancet published a report finding that Black and Latinx people, along with Indigenous Americans, are about three times as likely to be hospitalized and twice as likely to die from COVID-19 than their white, non-Hispanic counterparts in the U.S. Consider that alongside the fact that low-wage workers experienced some of the heaviest job losses during the height of the COVID-19 pandemic in 2020, and it’s clear that income and social stability is a crucial factor in ongoing positive health outcomes.
Solving the Burden of Disease by Social Status
The burden of disease by social status has never been clearer. Unfortunately, solving the underlying problems has proven to be a politically complex issue. In Nature, Maxmen cites one major investigation in the United Kingdom in 1980 which urged the government to raise taxes on the wealthy and invest heavily in public health, education, and social services, all in an effort to begin resolving disease disparities. Maxmen explains that, unfortunately, “the recommendations gained no traction with leaders at the time.” The problem hasn’t improved since that investigation. Looking back at the 2020 Lancet report, researchers urged U.S. officials to consider tactics like higher wages and immigration reform as a means to reduce disparities in health outcomes. Ultimately, it seems that large-scale federal intervention is necessary to improve outcomes in the U.S. and beyond.
The evidence is clear: lower-income individuals in underserved communities bear the brunt of the burden of disease by social status. Until holistic action is taken, the health discrepancies between the haves and the have-nots may well grow more extreme.
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